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帕金森病深部脑刺激的长期满意度和以患者为中心的结果

Long-Term Satisfaction and Patient-Centered Outcomes of Deep Brain Stimulation in Parkinson's Disease.

作者信息

Karl Jessica A, Ouyang Bichun, Colletta Kalea, Verhagen Metman Leo

机构信息

Movement Disorder Section of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison Street, Suite 755; Chicago, IL 60612, USA.

Department of Neurological Sciences, Loyola University Medical Center, 2160 S. 1st Ave.; Maywood, IL 60153, USA.

出版信息

Brain Sci. 2018 Apr 1;8(4):60. doi: 10.3390/brainsci8040060.

Abstract

Bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective and proven treatment option for patients with advanced Parkinson's disease (PD). Long-term outcomes (>5 years) have demonstrated sustained improvement in objective motor symptoms; however, few studies have evaluated patient-centered outcomes other than quality of life (QOL). A locally developed DBS-patient-centered outcomes questionnaire was administered to PD patients >5 years post-DBS. All questions were scored on a ten-point scale, whereby 0 represented the most 'positive' answer and 10 the most 'negative' answer. Pre-operative scales were repeated at the time of survey. Fifty-two patients (mean 8.2 ± 2.6 years post-DBS) were included. Satisfaction was high with median score (range) of 1/10 (0-8) at the time of survey. Patients endorsed having made the correct decision by undergoing DBS, with a score of 0 (0-10), would choose to have DBS again, with a score of 0 (0-10), and would recommend DBS to others, with a score of 0 (0-10). Pre-operative expectation target was set at a high level with a score of 2 (0-10). Parkinson's Disease QOL (PDQ-39) Questionnaire Summary Index (SI) scores were, mean (SD), 2.1 (18.2) above baseline ( = 0.44). Those with worsening in PDQ-39-SI scores had less satisfaction with DBS ( = 0.57, ≤ 0.0001). This is the first study to assess long-term patient satisfaction with STN DBS. We are currently collecting data prospectively to confirm the results of these preliminary findings.

摘要

双侧丘脑底核(STN)深部脑刺激(DBS)是晚期帕金森病(PD)患者一种有效且已得到证实的治疗选择。长期结果(>5年)显示客观运动症状持续改善;然而,除生活质量(QOL)外,很少有研究评估以患者为中心的结果。对DBS术后超过5年的PD患者进行了一项本地开发的以DBS患者为中心的结果调查问卷。所有问题均采用十分制评分,其中0代表最“积极”的答案,10代表最“消极”的答案。术前量表在调查时重复使用。纳入了52名患者(DBS术后平均8.2±2.6年)。调查时满意度较高,中位数评分为1/10(范围0 - 8)。患者认可接受DBS是正确的决定,评分为0(0 - 10),会再次选择接受DBS,评分为0(0 - 10),并会向他人推荐DBS,评分为0(0 - 10)。术前期望目标设定为较高水平,评分为2(0 - 10)。帕金森病生活质量(PDQ - 39)问卷总结指数(SI)得分平均(标准差)比基线高2.1(18.2)(P = 0.44)。PDQ - 39 - SI得分恶化的患者对DBS的满意度较低(P = 0.57,r≤0.0001)。这是第一项评估STN DBS长期患者满意度的研究。我们目前正在前瞻性地收集数据以证实这些初步发现的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e943/5924396/7fd825009163/brainsci-08-00060-g001.jpg

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